Trends in influenza vaccination coverage in Portugal from 1998 to 2010: effect of major pandemic threats.

BACKGROUND: Vaccination is the key measure available for prevention of the public health burden of annual influenza epidemics. This article describes national trends in seasonal influenza vaccine (IV) coverage in Portugal from 1998/99 to 2010/11, analyzes progress towards meeting WHO 2010 coverage goals, and addresses the effect of major public health threats of the last 12 years (SARS in 2003/04, influenza A (H5N1) in 2005/06, and the influenza A (H1N1)2009 pandemic) on vaccination trends. METHODS: The National Institute of Health surveyed (12 times) a random sample of Portuguese families. IV coverage was estimated and was adjusted for age distribution and country region. Independence of age and sex coverage distribution was tested using a modified F-statistic with a 5% significance level. The effect of SARS, A (H5N1), and the A (H1N1)2009 pandemic was tested using a meta-regression model. The model was adjusted for IV coverage in the general population and in the age groups. RESULTS: Between 1998/99 and 2010/11 IV, coverage in the general population varied between 14.2% (CI(95%): 11.6%-16.8%) and 17.5% (CI(95%): 17.6%-21.6%). There was no trend in coverage (p = 0.097). In the younger age group (<15 years) a declining trend was identified until 2008/09 (p = 0.005). This trend reversed in 2009/10. There was also a gradual and significant increase in seasonal IV coverage in the elderly (p for trend < 0.001). After 2006/07, IV coverage remained near 50%. Adjusting for baseline trends, there was significantly higher coverage in the general population in 2003/04 (p = 0.032) and 2005/06 (p = 0.018). The high coverage observed in the <15-year age group in season 2009/10 was also significant (p = 0.015). CONCLUSIONS: IV coverage in the elderly population displayed an increasing trend, but the 75% WHO 2010 target was not met. This result indicates that influenza vaccination strategy should be improved to meet the ambitious WHO coverage goals. The major pandemic threats of the past decade had a modest but significant effect on seasonal influenza vaccination. There was an increase in vaccine uptake proportion in the general population in 2003/04 and in 2005/06, and in individuals <15 years old in 2009/10.

[Self-reported hearing-loss in the Portuguese population: evidence from the 4th National Health Survey]. / Incapacidade auditiva autodeclarada na população Portuguesa: uma análise aos dados do quarto Inquérito Nacional de Saúde.

UNLABELLED: Hearing loss is associated with a negative social impact, which implies a lower quality of life. Despite its negative consequences the prevalence of hearing loss in the Portuguese population is not well known. OBJECTIVE: The aim of this study was to assess the prevalence of self-reported hearing loss, in a representative sample of the Portuguese population. METHODS: We analysed data from the 4th Portuguese National Health Survey (2005-2006), conducted by the National Institute of Health, Dr. Ricardo Jorge and the National Institute of Statistics. Participants were selected from households in the seven regions of Portugal (NUTS II classification), using a multi-stage random probability design. Trained interviewers conducted face-to-face interviews in each household and obtained information on social and demographic characteristics, and hearing loss situation. The prevalence of self-reported hearing loss was estimated by sex, age group, región and level of education. RESULTS: The prevalence of self-reported hearing loss was higher in men, and increased with age, in both sexes. The crude prevalence of hearing loss was higher in Alentejo region (11,0% in men and 9,5% in women) than in any other Region. After age-adjustment, the Northern región had the highest percentage (11,6%), and the Alentejo region the second value (9,7%). The Madeira Region had the lowest age-adjusted prevalence (5,0%). The percentage of hearing loss decreased with higher education, for most age groups both in men and women. CONCLUSIONS: This study showed that hearing loss was associated with high age groups, male gender and lower level of education. Facing this situation, it is important to promote epidemiological and clinical investigation about hearing loss, including associated exposures and their distribution in Portuguese populations.

[Influenza vaccination: coverage of Portuguese population from 1998/1999 a 2002/2003]. / Vacinação anti-gripal: cobertura da população portuguesa entre 1998/1999 a 2002/2003.

Between 1999 and 2003 the Portuguese National Health Observatory, has conducted four telephone surveys (1998/99, 1999/00, 2001/02 and 2002/03) using the ECOS - Em Casa Observamos Saúde - panel of Portuguese families, with telephone aiming at studying the influenza vaccination coverage of the mainland Portuguese population. From the results it can be highlighted: The percentage of individuals that declared to have taken the influenza vaccine, showed a consistent increase between 1998/99 (14.2%) and 2001/02 (17.0%), and a decrease in 2002/03 (15.0%), without statistical significance. In 2002/03, the age group 65 years and older had the highest coverage of influenza vaccination (36.9%). The lowest percentage occurred in the 15 - 44 age group (7.0%). The individuals that declared to suffer from chronic diseases (asthma, rheumatic disease, hypertension and diabetes), showed higher coverage when compared with the general population. The highest values were verified in individuals that declared to suffer from diabetes (34.5%) and asthma (34.3%). Based on these results, it figures out important to promote a larger coverage of the influenza vaccination in the individuals with 65 years or more, once this coverage is not sufficiently high, if compared with the estimates from other European countries. Although there are no European estimates to compare with, it seems equally necessary to take measures to improve the coverage, in the risk groups studied, as well as in others risk groups that were not included the present study.